n of the residency-integrated microsurgery course leads to significant and quantifiable improvement in resident microsurgical skill and efficiency.BACKGROUND Many surgeons are reluctant to discontinue prophylactic antibiotics after 24 hours in tissue expander breast reconstruction (TEBR) because of fear of increased risk of surgical site infection (SSI). Currently, there is no consensus regarding antibiotic prophylaxis duration in TEBR. In addition, there remains a lack of research investigating microorganisms involved in SSI across various perioperative antibiotic protocols. The purpose of this study was to examine how 2 different prophylactic antibiotic regimens impacted the bacterial profiles of SSI and rate of implant loss after TEBR. METHODS A single-institution retrospective review of immediate TEBRs between 2001 and 2018 was performed. Surgical site infections requiring hospitalization before stage 2 were included. Highly virulent organisms were defined as ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter species). Implant loss was defined as removaln groups 1 and 2 (62.5% vs 62.1%, P = 0.969) respectively, was nearly identical. CONCLUSIONS Our study demonstrates that, despite differences in bacterial profiles between 2 antibiotic protocols, prolonged postoperative antibiotic use did not protect against overall highly virulent infections or implant loss. Antibiotic stewardship guidelines against the overuse of prolonged prophylactic regimens should be considered. Further analysis regarding timing of SSIs and antibiotic treatment is warranted.PURPOSE The aim of this study was to evaluate magnetic resonance imaging (MRI) findings in cases of fatal manual or ligature strangulation. Verification of strangulation by computed tomography (CT), MRI, and at autopsy as well as its detectability in each modality was assessed. METHODS We retrospectively analyzed 6 manual and ligature strangulation cases between 2013 and 2019 who all underwent a whole-body CT, head and neck MRI, and an autopsy. Two radiologists examined head and neck imaging data and compared the data to autopsy findings. RESULTS Magnetic resonance imaging showed a high efficiency in verifying intramuscular hemorrhages, which were confirmed in autopsy. Moreover, in one case without a visible strangulation mark, soft tissue injuries associated with strangulation were detected. Fractures, especially thyroid cartilage fractures, were successfully diagnosed by CT. CONCLUSIONS As MRI showed a successful detection of soft tissue lesions in relation to strangulation, it can serve as an alternative method or provide additional value to an autopsy. Intramuscular hemorrhages are a common finding in manual and ligature strangulation, providing a useful sign of applied pressure on the neck. However, to evaluate fractures, an additional CT or autopsy is recommended.We report 2 unusual autopsy cases with head handgun wounds using defective firearms in a suicidal context. In the first case, a 78-year-old man was found hanged from a tree, with a Lefaucheux revolver lying on the tree. In the right temporal region, there was an entrance wound with a bullet still in place, responsible for a mild cerebral contusion, without bone defect. The main cause of death was hanging. In the second case, a 60-year-old man died at home after shooting himself in the head several times with a 22-long rifle revolver. The autopsy showed 13 entrance wounds on the scalp. Most of the bullets remained along the skull vault. In each of 2 cases, the manner of death, the feasibility of suicidal gesture, and the consequences of a brain injury on the time to the occurrence of incapacity were questioned. These unusual autopsy cases underline how important it is to take into account the defective nature of firearms.Hemorrhagic petechiae in the conjunctiva and the skin have been related to type of suspension and body height of the victims of hangings. In 265 cases of hanging, we retrospectively examined whether petechiae relate to type of suspension, body weight and height, body mass index (BMI), age, sex, type and thickness of the ligature, and blood alcohol content. The type of suspension was divided into completely suspended, incompletely suspended, and found with feet touching the ground. There was no significant difference in the frequency of petechiae between the feet touching the ground and complete suspension, and they were therefore considered as one group (complete suspensions). Incomplete suspensions had more (58.7%) petechiae than the complete suspension group (30.2%). Statistical analysis showed that incomplete suspension was significantly stronger related to the development of petechiae than complete suspension. Body mass index was the only variable able to add information to the type of suspension. In victims of incomplete hangings, high BMI yielded 2.58 times higher probability of developing petechiae than low BMI. These findings suggest that body size may contribute to the development of petechiae in hangings.Organ weights are routinely measured during autopsies as a crude screening tool to detect possible organ pathology. In several centers, inclusion of major organ weights indicates whether an autopsy report has achieved its standard of practice, which in turn should be subjected to an audit. Previous studies show statistical variation in organ weights across different populations. Malaysian pathologists have relied on Western data and crude subjective determination in the interpretation of normal organ weights. Hence, the need for a reference range as a guide for pathologists is acute. Organ weights from traumatic deaths between 2004 and 2017 were analyzed in the UKM Medical Centre. Statistical analysis was performed to form reference ranges for normal weights of the brain, heart, lung, liver, spleen, and kidneys. In addition, the data were compared between sexes, races, and body mass index values to determine whether organ weights were affected by these parameters. https://www.selleckchem.com/products/rk-33.html In this study, reference ranges for organ weights are presented for Malaysian adult men and women.